4 Reasons for Knee Pain During Cycling

Although cycling is considered a low-impact sport, many cyclists will end up with knee pain at some point in their training. There are so many factors at play in regards to the bike itself, your body in motion, and how the two interact. It can be hard to isolate the cause of your knee pain, but understanding the location of the pain and potential causes can help you avoid future occurrences.


Saddle Height

You may experience pain along the back or outside of the knee when the seat is too high. When you are reaching too far for the pedals, the hamstring tendon and the iliotibial band are overstressed and may become sore.

When the saddle is too low, you may experience pain around the kneecap due to the additional stress on the patellofemoral joint. You saddle should be adjusted to allow for 27 to 37 degrees of knee flexion to reduce overexertion.

Saddle Positioning

Riding with your saddle too far forward can cause pain in the front of the knee. Many riders feel that they can get more power by leaning forward, but it can actually cause unnecessary stress on the patellar tendon.

Moving your saddle back can alleviate some of the pain in your knee. However, a saddle that is too far back can cause pain in the back of the knee due to overextension. If necessary, visit a bike fitting specialist to make sure your seat is properly adjusted.

Foot Placement

Even something as simple as foot placement on the pedals can impact your knee or cause pain. Most commonly, cyclists will experience pain on the inside of their knee. If your feet are too close together or too far apart, the knee is pushed inward or outward during pedaling, causing unnecessary stress on the joint.

When positioning your cleats, align your knee with your feet so the force is directed vertically through your lower leg to avoid excess stress on the knees.

Overexerting Yourself

Any of the knee pain described can also be evident of overtraining. Difficult courses or strenuous hill climbs can take a toll on your body, particularly if you normally cycle on flat ground. Increasing your mileage by more than 10% each week can harm your knees or lead to injuries in other parts of your body as well.

Allow yourself recovery time after strenuous rides, and increase your mileage gradually to reduce the risk of injuries. Most of all, seek treatment when necessary and give yourself time to relax.

Treatment for Knee Pain

Dr. Heiden was an Olympic athlete and understands the risks and rewards associated with pushing yourself. Cyclists who experience knee pain can seek treatment from an experienced doctor who understands non-surgical and surgical treatment options. Your treatment may include:

  • Rest and relaxation at home for minor injuries
  • Pain medication
  • Physical therapy
  • Surgery

In addition to treatment, it is recommended that you make appropriate adjustments to your bike and riding techniques in order to avoid future injuries. Dr. Heiden will create a customized treatment plan to alleviate your knee pain and help you get back on your bike as soon as possible.


Great Article
Thank You


Great info, especially the need to find a professional, highly experienced bike fitter!


I like what you said about making sure you’re not overexerting yourself to avoid knee pain. My brother recently got in a cycling accident and will probably have to go to an orthopedic surgeon. I hope that he can get the treatment he needs for his knee injury so that he can continue to be active and exercise.


    Thanks for your question. Bike adjustments for knee pain can really vary depending on the location of pain in the knee. For example, riding with the saddle too far forward can cause pain in the front of the knee; whereas poor cleat alignment may be causing pain on the inside of the knee. We recommend seeking out a professional bike fitter to ensure proper alignment to alleviate knee pain – it’s worth the time! Most bike shops will be able to help you make adjustments or guide you towards a trained professional. Hope this helps!


    I’m not sure there are specific bikes for arthritis (though there could be), but a hybrid bike can be extremely helpful for someone with arthritis. Hybrid bikes often require less strenuous pedaling, which can be easier on your joints. Another option would be a recumbent bike. The seat on a recumbent bike helps to evenly distributes the weight of your body, often relieving the pressure on your shoulder, hip and knee joints. Lastly, there’s an electric bike πŸ™‚ The advantage here is you can take a break when needed, which can help with the strain on your joints.


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